The Centers for Disease Control and Prevention (CDC) is reminding clinicians seeing patients from the areas affected by Hurricane Florence to maintain a high index of suspicion for CO poisoning. Other people who may be exposed to the same CO source may need to be identified and assessed.
The signs and symptoms of CO exposure are variable and nonspecific. A tension-type headache is the most common symptom of mild CO poisoning. Other symptoms may include dizziness, flu-like symptoms without a fever, drowsiness, chest pain, and altered mental status.
Clinical manifestations of severe CO poisoning include tachycardia, tachypnea, hypotension, metabolic acidosis, dysrhythmias, myocardial ischemia or infarction, noncardiogenic pulmonary edema, neurologic findings including irritability, impaired memory, cognitive and sensory disturbances, ataxia, altered or loss of consciousness, seizures, coma, and death, although any organ system might be involved.
Although CO poisoning can be fatal to anyone, children, pregnant women, the unborn, persons with sickle cell disease, older adults, and persons with chronic illness (e.g., heart or lung disease) are particularly vulnerable.

The Israeli Ministry of Health is reporting an outbreak of leptospirosis in persons with exposure to natural water sources in the Golan Heights region of northern Israel after July 1, 2018. As of September 6, 2018, three persons with leptospirosis who traveled to Israel have been identified in the United States, with additional suspected cases reported and under investigation. Early symptoms of leptospirosis include fever, headache, chills, muscle aches, vomiting, diarrhea, cough, conjunctival suffusion (conjunctival redness without exudates), jaundice, and sometimes a rash. Clinicians should consider leptospirosis as a diagnosis in any patient who develops an acute febrile illness within 4 weeks of travel to one of the areas in northern Israel listed below since July 1, 2018.

This Health Alert Network (HAN) Update is to alert public health departments, health care professionals, first responders, and medical examiners and coroners to important new developments in the evolving opioid overdose epidemic, which increasingly involves illicitly manufactured fentanyl and an array of potent fentanyl analogs (i.e., compounds that are chemically related to fentanyl). It is the second update to the original health advisory, HAN 384, issued October 26, 2015, which alerted the public to the increase in unintentional overdose fatalities involving fentanyl in multiple states, primarily driven by illicitly manufactured fentanyl. The first update to this health advisory was released on August 25, 2016 (HAN 395), describing the sharp increase in the availability of counterfeit pills containing varying amounts of fentanyl and fentanyl analogs, the continued increase of overdose deaths involving fentanyl across a growing number of states, and the widening array of fentanyl analogs being mixed with heroin or sold as heroin.
The current update includes information on: (1) the continued increase in the supply of fentanyl and fentanyl analogs detected by law enforcement; (2) the sharp rise in overdose deaths involving fentanyl and fentanyl analogs in a growing number of states, in particular the growing number of deaths involving the ultra-high potency fentanyl analog known as carfentanil; (3) the expanding number of poly-drug combinations implicated in opioid overdose deaths, which include non-opioids, such as cocaine; (4) the updated comprehensive guidance available to law enforcement and other emergency responders to prevent occupational exposure to fentanyl and fentanyl analogs; and (5) updated recommendations for public health professionals and health care providers regarding prevention and response efforts.

The Centers for Disease Control and Prevention (CDC) and state health departments are investigating hepatitis A outbreaks in multiple states among persons reporting drug use and/or homelessness and their contacts. This Health Alert Network (HAN) Advisory alerts public health departments, healthcare facilities, and programs providing services to affected populations about these outbreaks of hepatitis A infections and provides guidance to assist in identifying and preventing new infections.

This Health Alert Network (HAN) Update provides current recommendations on management and reporting of Shigella infections that have been treated with ciprofloxacin or azithromycin and resulted in possible clinical treatment failure. This is a follow-up to HAN 401: CDC Recommendations for Diagnosing and Managing Shigella Strains with Possible Reduced Susceptibility to Ciprofloxacin (https://emergency.cdc.gov/han/han00401.asp).

The Centers for Disease Control and Prevention (CDC) is providing information on: 1) the current status of a multistate outbreak of coagulopathy from exposure to synthetic cannabinoid products containing a vitamin K-dependent antagonist agent, such as brodifacoum; 2) signs and symptoms of presenting patients from this outbreak and which patients are at risk; 3) laboratory testing options that are available to help identify and classify cases; 4) available resources that may help clinicians make decisions; and 5) to whom to report possible cases.

April 2, 2018 | Posted by CDC Emergency Preparedness and Response: What''s New

Health communication and marketing campaigns that promote positive behavior change are a cornerstone of public health and behavioral science. Designing and implementing quality campaigns on a tight budget and in an urgent timeframe is a challenge that most health communication professionals share. Research and evaluation are critical for a successful campaign. CDC is using leading research and evaluation methods to develop quality campaigns, while keeping costs low and sticking to tight timelines.

March 26, 2018 | Posted by CDC Emergency Preparedness and Response: What''s New

What if there was a way to evaluate the needs of a community after a natural disaster? Or understand a community’s attitudes and beliefs about a specific public health behavior? Enter CASPER: Community Assessment for Public Health Emergency Response, a tool for health departments and public health professionals to assess community needs in real-time.

March 19, 2018 | Posted by CDC Emergency Preparedness and Response: What''s New

Let’s face it: your colon isn’t exactly a dinner party topic. It takes a lot of guts to bring up colorectal cancer—to your parents, your spouse, your doctor, your friends. Don’t be afraid to pipe up about the second-leading cancer killer of both men and women, because it’s proven that simple steps save lives.

March 12, 2018 | Posted by CDC Emergency Preparedness and Response: What''s New

Communication experts often say, “When you’re communicating during an emergency, always think about what you’d say to your mom. What information would she need the most? How would you explain it to her? What would you need to know for sure before you told her? And just how far would you go to reach her?” When Hurricanes Irma and Maria hit the U.S. Virgin Islands (USVI) in September 2017, this wasn’t just advice for Nykole Tyson. Nykole is the USVI Department of Health’s (DOH’s) Director of Public Relations. She serves as the DOH spokesperson and emergency communicator. Like all of USVI’s responders and government officials, she is a survivor who was impacted by the storms. Nykole’s home had water and roof damage and she was without water or power for four months. “I caught rain water in barrels and used solar lights sent to me by friends living stateside,” Nykole said. She lived on a cot in her office in the DOH for several weeks between and after both storms. . The storms destroyed most of the territory’s communication infrastructure, making both personal and mass communication nearly impossible. Nykole was unable to reach her own family for four days after the second hurricane. However, within hours of both storms, she was on the radio talking to her community about how to stay safe, find shelter, and stay strong. Nykole wasn’t just talking to the public, she was talking to her neighbors, her community, her family, and even her mom.